We established the UCSF Clinical and Translational Science Institute (CTSI) at the University of California, San Francisco (UCSF) in 2006 to accelerate the pace of research that improves the health of the public. The overall mission of CTSI has been to improve and transform clinical and translational research infrastructure and training at UCSF and our partner institutions. In the next funding period we aim to use the substantial knowledge, skills, and infrastructure that we have developed to further accelerate the pace of research at UCSF, to export our successes to other institutions, and to create initiatives aimed at improving the health of our own and other communities, through the following aims: SPECIFIC AIM 1: To enhance the highly successful activities of the UCSF CTSI, including the development of new initiatives in the areas of Training, Infrastructure/Services, and Advocacy/Culture Change: a) Training: to provide programs for students at all levels, across a spectrum of settings, and including all phases of the improvement of healthcare; b) Infrastructure/Services: to expand services and tools to clinical and translational investigators at UCSF, our partner institutions, and within the broader regional, national, and global communities; and, c) Advocacv/Culture Change: to nurture communication, encourage collaboration, foster innovation, and catalyze the successful conduct of clinical and translational research; to support a diverse faculty; to increase involvement of the community and the responsive of research to its needs; and change the academic culture to promote multidisciplinary, collaborative work. SPECIFIC AIM 2: To develop crosscutting initiatives using the knowledge, skills, and infrastructure developed by multiple CTSI programs in the first funding period to accelerate clinical and translational research and its impact on health, well beyond the institutions collaborating in the UCSF CTSI. New initiatives will: a) Bring together local public health and philanthropic groups to work with CTSI to improve the health of the San Francisco Bay Area community through a series of health improvement projects directed at high impact conditions; b) create a model system to accelerate the pace of clinical and translational research that includes streamlining regulation, developing participant recruitment services, providing research management, and bringing research services directly into community practices; and, c) improve the performance, transparency and accountability of research administration within and beyond CTSI by setting challenging goals and tracking performance metrics on public dashboards. These aims will be achieved by orchestration of activities occurring within and between our 10 programs, supported by a proven governance model, and with strong ties to institutional and community leadership. Our ultimate goal is to bring better health to more people more quickly.